La colecistectomia laparoscopica in day-surgery: analisi di fattibilità su 166 pazienti consecutivi

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M. Nardi Jr., S.G. Perri*, F. Gabbrielli,S. Felici, A. Nicita*, F. Pietrangeli, A. DallaTorre*, R. Lotti, A. Moraldi*, G. Citone

Ann. Ital. Chir., LXXVI, 1, 2005

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Background: Day-Surgery (DS) is a widely spreading reality,
both for clinical advantages to patients and organizational
and economic profit to hospitals. In the last years,
DS has been proposed for the treatment of a large number
of diseases as inguinal and crural hernias, varicose vein,
benign anorectal and thyroid pathologies. Recently, also laparoscopic
cholecystectomy (LC) has been realised as DS procedure,
and the initial results are promising.
Objectives. To determine both the clinical feasibility of LC
in DS and the factors that can predict an extension of
hospital stay.
Materials and methods: The present study is a retrospective
analysis of 166 patients who underwent surgery because
of symptomathic cholelithiasis in a three-year period; all
patients underwent elective LC in ordinary hospital-stay. In
order to identifying the patients potentially eligible for LC
in DS, we carried on a selection by means of 3 consecutive
stages: stage A, selection on the basis of preoperative
data, stage B, selection on the basis of intraoperative factors
and stage C, selection on the basis of postoperative parameters.
Results: Out of 166 patients, only 33 (19,8%) would have
been successfully treated in DS.
Conclusions. This study showed that LC in DS can be realised
in strictly selected patients, on the basis of rigorous
clinical and organitational criteria; furthermore, a continuos
training of surgeons and nursing staff, the implementation
of telemedical facilities and the improvement of anesthesiological
techniques will allow to the best results.

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